Aug 25 2011
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Saving the Day... and the Family Vacation

Allison Stevens is a writer based in Washington, D.C. She writes about women’s issues, motherhood, politics and health, and also writes for a firm that works for the Robert Wood Johnson Foundation.

file Allison Stevens

At the beginning of the summer, my family and I took a road trip to the wilds of West Virginia. Owen, our two year old, had a cough, but my husband and I decided to go anyway. If we postponed every outing because of a sick child, we said to ourselves, we’d never get out of the house.

It didn’t take long before we began to regret that decision. Typical, right?

About two hours into the trip, Owen’s cough had gotten much worse. He was coughing non-stop, and couldn’t seem to get a deep long breath in. We decided we had better head to the nearest emergency room. When we finally arrived at the small ER in rural West Virginia (thank you GPS!), we were told that the wait would be several hours long.

So much for our trip, we sighed.

The triage nurse, however, suggested we instead try the new urgent care clinic a few miles down the road. We retraced our steps, driving about a half hour back toward Washington, D.C., and headed into the brand new facility.

We walked into the small, clean white building and found we were the only customers—even though lots of folks were waiting to see the docs down the road. Our boys played in a small play area with children’s toys while I filled out the requisite health forms, and before long we were called in to see the nurse practitioner on call.

She took a look at Owen and quickly summed up the situation. Owen had croup, his throat was swollen—threatening to block off his airway—and his oxygen levels were dangerously low. We shouldn’t drive farther into the mountains, where health providers are few and far between, before resolving these issues, she warned.

The nurse practitioner put Owen on a nebulizer, gave him a steroid treatment and some other medication, and her assistant monitored Owen’s oxygen levels. Within about 15 minutes, Owen was—to my amazement—breathing easily. His oxygen levels had climbed back to the high 90th percentile, his cough had eased, and his throat seemed back to normal.

The nurse practitioner handed us scripts for three prescriptions, and we made a brief stop at the nearby pharmacy before heading to Blackwater Falls State Park.

Thank God for the nurse practitioner! She saved us from a long afternoon in the emergency department, she saved Owen from an uncomfortable, and potentially dangerous weekend, and—the cherry on top—she saved our vacation too. Because of her, we were able to spend a wonderful long weekend together.

As thanks, I’d like to take a little time to sing the praises of an unsung hero in today’s health care system: the nurse, the kind of health provider who has a lot to contribute to improving our nation’s ailing health care system.

Physicians are in short supply, especially in rural areas, making it often difficult to access primary care—even for routine coughs and sniffles or broken toes. The shortage is on track to worsen in a few years, when millions more are able to purchase insurance thanks to the new health reform law.

At the same time, the cost of health care is soaring, putting even basic health care out of reach for many, especially those who don’t have insurance or who live in remote areas. Those lucky ones who do have health insurance (ourselves included) often have trouble accessing care on the weekends and in the off-hours, even if they live near a health care facility. Many doctors’ offices are closed after hours and on weekends—and that’s when my kids, at least, seem to get their sickest.

That leaves the most expensive option—the emergency room—the only available one for millions of insured and uninsured people in need of urgent care, as it was in our case this summer.

One way to avoid this trap? Nurses and nurse-led care.

Studies show that nurses are as adept at providing certain primary care services as doctors are, and that was certainly my experience in West Virginia. Nurses charge less for their services. And many practice off-hours or on weekends—especially at so-called “minute clinics,” the nurse-led health care clinics at big-box stores like Target and Rite-Aid.

Fortunately, nurse-led clinics are popping up all over the country. There are now more than 200 retail clinics around the country, and the number of nurses providing primary care is expected to grow as demand for accessible, affordable health care intensifies.

I look forward to taking advantage of the boom in nurse-led care—and avoiding the dreaded ER the next time one of the kids gets sick when we least expect it!

Tags: Emergency care, Health care delivery system, Human Capital, Nurse practitioners, Nursing, Voices from the Field